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HomeMy WebLinkAboutPermit Mechanical 2010-8-19 08/18/2010 14:44 5413430590 MIDGLEY5 PAGE 01/01 , ; , -' iMechanical Permit Application CITY OF SPRINGFIELD. OREGON :U5 Fifth Strccl: . Springfield, OR. 97477 . PH(541)726-3753 . FAX(S41)72li-3f=jl.{9 IICI'A'~~lD.D":"" ; (~.I '. ... ,t'C,~c.t:.".;! Dale: 0;--- /1 ---/ 0 :i:::i)i!i~lt~~N~:14~,'\6iJL . g' The. permit b ."ued under OAR 913-440-0050, Permits expire if work is not started wltbin 180 days olissuante or if work is ,uspeoded for 180 days. ,(,."t:A:'Il!~~l'ty,:.:tjF! '$('lN$tR:lJ~tldl'l,!:,'... .'....'. ""'.' .",. '::""):/:;1!;\~;:::i:~.:;~;i:!;;!i:'i';:\;.;S,::i;;);H~E:"i:~St1:f:SjO~;;il)\liHl;!!!!lll:ii\('::,::.I~::~.\,~;;),<::'::,;ii;);~>j !;~td!il!~I~i':'.::):::i.:,::.:,:I!:~!::."'!I':jP!;}:illflli1!' ~:'I::\iii~'II"ii ''''"ifl9la1' ":;:":&!!!.I!l!I:,.,. \~"'K~I~i':'" ':,:~,':' Pll ~:' first At7bHonce I :rT~,00 $ urnRce.lburner il1chu1in~ duelS and vents Up I<> 1001< BTUlhr, I I $17,00 I $ Over lOOk BTUIhr, $20,00 I $ Heaters/stoves/vents Unit heater $17,00 $ Woodlp~l1ctlga5 :stove/flue \ $38.00 $ 3<;;1 R%air/a1ter/add to h~ting appliafloe! re rigeration uoit or cooling system! $58.00 $ absoft,ti(m system Ev:!'ponned cooler $13,00 $ Vent fan with on~ duct/appliance vent $9,00 $ Hood with erllausl Qnd dud; $13,00 $ Floor fumace,inc.luding vent $58,00 $ Ga, pipinll One to foul' outlets I I $7.00 $ Additional outlets (each) I I $4,00 $ Air-bal1dliu", unlts, il1c1uding duet, Up [0 10,000 CfM I I $11,00 I $ Over 10.000 crn I I $20,00 I $ Compressor/ab'orotlol1llVStemlbeat purDp Up '" 3 hpllook BTU $17,00 $ Up to 15 hpl500k BTU $28.00 $ Up to 30 hpll ,000 BTU S4J,OO $ Up t. 50 hp/l, 750 BTU $57.00 $ 0"",50 hpll,750 BTU $85,00 $ Incinerators Donl.l:stic incineratQr I $20.00 I $ ;'eortl~liC!l!ir:;'!lliiili'{ii'lill",ii'i"." .,.'.' 'i",i..' , ',:,'.: :)!i:(i;i~~;i ;(;!!~ ii~i!H~' ~ri'..l.,!:' ,::I\':"~ .. ::e.~ ~I::. ~ ;\I~l" ~.., . . , . ,;.. \ ,; I ". "l I ,.~ "'i"'. '.1 i';, .... ..,.', I ' Etlter totoal valuation of me chaniea 1 SYS~1Tl and installation cos~ S Enter fix: based on valuation of mechanical system, c:tt., $ 'MISC~ilmllMlIjlfdf"" .' . !~: ""ilillilll"",,"'''''m~&I'''' .:"~ ';', .. ,.:.,: .. ..... '", " . ". ~ ',' .:. .}.!!~C%f':i!i,:!!!i!!:~!.iIIU! "i!ill, 'iQil:m" li!lii1i~ij~l";':'" ....,I >>;'" , Reinspa::tion $58.00 $ Specially requested inspc:;ctions (pet hr,) $58,00 $ Regulated equiptneTlt.(unclassed) $13.00 $ Elich additional inspection: (1) $58.00 $ ~:liii;ilili~ii'~Jili! 'I ~!illlll~~;'ii{,_ miIW'IU!'\ii", .. '" ',,, .... ,~ . t, I I" ],.~ I ' ,~.)I. ',..", I. (A) Enter subtotal ofsbovc fees (orentc::r set 'LI'\ minimum fee of $ll.2Q) $ (Il) Investigalive foc (equa'l<> [A]) $ (C) Enter 12% ",",harge (.12 x [1\+8]) $ (D) Seismic fee, 1% (.01 x [A]) S (E) Tcchf'l(llogy Fee (5% (If [An $ TOTAL fees Rnd surcl)...ge, (A thr'I)~.j;h E): $"17..'-\3 Re,idc:ntial 0 Government 0 Commercial ""''':iJ~I:lISIfl'EhjIllInOIiMJ,'tiO/<I,.:ANO.'t:i!ileA:tlllil~::::i:;''\ii:';:' Job site address: 5 q '3'1 MVI 1 V\.. '>'-\--v-ee+- City: r:-.A t2- ZIP: "Ii 'i"'" t .,..::.;:,.' ,;.1\:1;"'" Business name; Address: City: Phone: E-mail: CCB Iicrnse no.; Print name; Signatu.rc~ 440-2545-J (IIIOSICOM) INWW. ci, springfield. or. us /, CITY OF SPRINGFIELD 225 Fifth Sl Springfield,OR 97477 541-726-3753 permitcenter@ci.springfield.or.us DATE: 08/19/2010 RECEIPT NO: 2010000083 .i ,t~J,.t~~f;~ '" rt~, ' TRANSA~TidN RECEIPT RECORD NO: 8Il-SPR20 10-00088 . ..:::,-- , 'DESCRIPTIOI.,(/"l:" t"':::!::1f: l!.____,____"".. __, Firsl Appliance Fee I echnology fee (5% of permit total) State of Oregon Surcharge (12% of applicable fees),' - _i . '%~$':-' ;, .-~:';.;::/",~~:,6;CCOUNT~C.ODE"::;::j~c c',; ,_"MOUNT_DUE~-: . ...224-00000-425604 "- . , .'100-00000-425605 :: 821-00000-215004 TOTAL DUE: ~"'PAYMENTiYJ:"'E~~RAYOR:'~CASHIER\&M~C]t\Q:Q,l;~:c6MMEr-jis~-Ii. ~:-"" :";/';:;'-'I"'-"j,:1"/1 Credit Card THERMAL RESOURCES INC 044284 .,;l{::.o" J;;,.: ':;.;Ii,'(" d('" "" . , " .. "'" 1'\. ~; *,,: ':' ~'.;;f9:!;' ,..'f;1,;..t , l~t. ,', - . " -,. . ~ I' -." $79.00 $3.95 $9.48 $92.43 ;!A'MOUNTPAID!!'@';~. $92.43 ",' " .1 ..~